Evaluation of postoperative pain in endodontic retreatment with apical periodontitis using ozonated 2% chlorhexidine and 0.1% octenidine application: A randomized clinical trial.

Introduction: This study aimed to evaluate and compare postoperative pain (PP) in single-visit nonsurgical endodontic retreatment (SV NSER) with 2% chlorhexidine (CHX), 0.1% octenidine (OCT) with or without ozone, and 5.25% sodium hypochlorite (NaOCl). Materials and Methods: In this randomized, parallel, prospective, double-blind, clinical trial, 132 single-rooted, root-filled teeth with symptomatic apical periodontitis (AP) requiring NSER were allocated into six groups randomly (n = 22/group): 2% CHX with NaOCl (CHXH), 2% Ozonated CHX without NaOCl (OCHX), 2% Ozonated CHX with NaOCl (OCHXH), 0.1% OCT with NaOCl (OCTH), 0.1% Ozonated OCT without NaOCl (OOCT), and 0.1% Ozonated OCT with NaOCl (OOCTH). Standard NSER protocol was followed groups were irrigated with 15 ml of ozonated or nonozonated irrigant (CHX/OCT) for 3-5 min with ultrasonic agitation. PP at baseline, after 6, 12, 24, 48 h, and 7 days was recorded using the Visual Analog Scale (VAS). Logistic regression of predictor variables was compared using the Chi-square test. For group-wise and time-wise comparisons, a two-way analysis of variance followed by the post hoc Bonferroni test was carried out. Results: None of the patient-related variables in logistic regression obtained a statistically significant (P > 0.05) role in PP. The VAS score after 6 h was OCHX (4.72) > OOCT (4.42) > CHXH (4.23) > OCTH (3.95) > OCHXH (3.42) > OOCTH (3.21). OOCTH and OCHXH groups demonstrated statistically significant reductions in VAS scores at various time intervals (P < 0.05). Conclusion: SV NSER with ozonated OCT, CHX irrigation, and NaOCl resulted in lesser PP at all time intervals, i.e., 6, 12, 24, 48 h, and 7 days in patients with symptomatic AP.

Bonding strategies to deal with caries-affected dentin using cross-linking agents: Grape seed extract, green tea extract, and glutaraldehyde - An in vitro study.

Aim: This study evaluated the effect of three collagen cross-linking agents - proanthocyanidins (grape seed extract [GSE] and green tea extract [GTE]) and glutaraldehyde [GA] on microshear bond strength (µSBS) of caries-affected dentin (CAD)-resin complex. Materials and Methods: Freshly extracted 96 teeth with caries up to the middle third of dentin were sectioned through the deepest part of the occlusal fissure, perpendicular to the long axis of the crown. Caries was excavated with large round bur until firm dentin was obtained, confirmed by visual inspection and tactile examination. Flat occlusal dentin surfaces were treated as follows: Group-1 - 6.5% GSE (n = 30), Group-2 - 2% GTE (n = 30), Group-3 - 5% Glutaraldehyde (n = 30), Group-4 - control group (no agents) (n = 6). Each group was further divided into Subgroup A - Etch-N-Rinse 15s, Subgroup B - Etch-N-Rinse 45s, and Subgroup C - Self-etch. Two increments of 1.5-mm thick composite (Tetric-N-Ceram - Ivoclar Vivadent) with a 1-mm diameter were built-up. Each sample was subjected to µSBS test in Universal Testing Machine. Student's t-test was done for intragroup comparison and one-way ANOVA for intergroup comparison. Results: Statistically significant difference was present in mean µSBS, with Group 1B showing the best results and Group 4C, the least. Conclusions: Thus, the application of these collagen cross-linkers, to CAD, increases µSBS and promises a new approach to improve dentin bond strength.

Efficacy of microabrasion and resin infiltration techniques for masking of fluorotic white spot lesions: A randomized clinical study.

Aim: The aim of the study was to compare the esthetic treatment outcome and quantification of tooth color changes using microabrasion and resin infiltration techniques of fluorotic white spot lesions (WSLs). Subjects and Methods: Sixty-six teeth with fluorotic small opaque white areas involving 25%-50% (very mild/mild fluorosis) of the surface were randomly assigned into two groups for microabrasion and resin infiltration techniques. To quantify tooth color changes, depicted by Delta E (DE), photographic analysis was performed using Adobe Photoshop CS5 Extended version by measuring Commission Internationale de l'Eclairage L*a*b* values of each tooth at two points, i.e. one at WSL and the other one at sound adjacent enamel. Statistical Analysis Used: Data were analyzed with t-test using SPSS software version 23. Results: L*value (decrease in whiteness) of posttreatment WSL decreased in both groups but was higher in the resin infiltration group, which was statistically significant. There were no statistically significant changes observed in a* and b* values of WSL in both groups. DE value difference of pre and postoperative was higher in the resin infiltration group, which was statistically significant which indicated the stability of color obtained by the resin infiltration group. Conclusions: Resin infiltration technique is more efficient in the immediate elimination of fluorotic WSL than microabrasion.

Evaluation of Ozone Therapy in Endodontic Treatment of Teeth with Necrotic Pulp and Apical Periodontitis: A Randomized Clinical Trial.

INTRODUCTION: The aim of this study was to compare the effect of different application techniques of ozone on the prevalence of postendodontic pain in patients undergoing single-visit root canal treatment. METHODS: hundred eight patients with necrotic pulp in single-rooted teeth and apical periodontitis participated in the trial. A standard single-visit endodontics protocol was followed with 5.25% sodium hypochlorite and rotary nickel-titanium files. After shaping and cleaning, patients were randomly allocated into the following groups: group 1 (n = 21), ozone treatment with no activation (NA); group 2 (n = 22), ozone treatment with manual dynamic activation (MDA); group 3, (n = 21), ozone treatment with passive ultrasonic activation (PUA); group 4 (n = 23), ozone treatment with sonic activation (SA); and group 5 (n = 21), no ozone treatment (the control group). Patient levels of discomfort were recorded at 6 different time intervals using the visual analog scale (VAS). Comparison of the mean difference between the groups and time intervals was performed using 2-way analysis of variance followed by a post hoc Bonferroni test. The level of significance was set at 5%. RESULTS: VAS scores were highest for the control > NA > MDA > SA > PUA groups. A statistically significant reduction in VAS scores was observed in the PUA and SA groups in comparison with the NA, control, and MDA groups. Timewise comparison showed a highly significant decline in VAS scores at all time intervals (P < .001). CONCLUSIONS: Ultrasonic and sonic activation of ozone resulted in less pain in patients undergoing single-visit endodontics compared with no ozone treatment.

A case report on endodontic management of the rarest Vertucci's Type VIII configuration in maxillary second molar with three mesiobuccal canals.

Anatomic variations in mesiobuccal root (MBR) of maxillary molars are common. This variation is found to be more common in maxillary first molars as compared to second molars. However, finding three independent mesiobuccal (MB) canals in the MBR of maxillary molars is clinically a rare entity. With the use of magnification, illumination, and cone-beam computed tomography, combined with the skill of the operator, there is an increased possibility of detecting such additional canals. The present case report describes the successful clinical management of a second molar in a 58-year-old female patient having three MBR canals (MB1, MB2, and MB3) with a Vertucci's Type VIII canal configuration and an almost obliterated pulp chamber. The canals were prepared using hand and rotary instruments, followed by obturation. Very few such cases have been documented clinically in the literature.

Effect of chemical cross-linkers on surface topography and microtensile bond strength of sound dentin: An in vitro study.

AIM AND OBJECTIVES: The aim of the study was to investigate the effect of two different collagen cross-linking agents proanthocyanidin (Grape seed extract [GSE] and 1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide) on the surface topography of etched dentin and microtensile bond strength (µTBS) of resin dentin bond. MATERIALS AND METHODS: Fifty-two sound human 3rd molars were collected, and their occlusal surfaces were ground flat to expose dentin. Dentin surfaces were etched using phosphoric acid and then teeth were randomly divided into four groups, according to the dentin treatment: Group 1: wet bonding technique, Group 2: dry bonding technique, Group 3: 6.5% proanthocyanidin, and Group 4: 0.1M carbodiimide. Scanning electron microscope analysis was done for twenty specimens (n = 5 per group) at ×10,000 and ×30,000 magnification. Remaining 32 specimens were restored with TETRIC N-Bond adhesive systems and resin composite. After 24 h, teeth were sectioned to produce a cross-sectional surface area of 1.0 mm2 and tested for µTBS. STATISTICAL ANALYSIS: Data were statistically analyzed using ANOVA and post hoc least significant difference test (P < 0.05). CONCLUSION: When acid-etched dentin is treated by 6.5% proanthocyanidin (GSE) and 0.1M carbodiimide, followed by application of adhesives, it results in increased µTBS due to cross-linking of collagen fibrils.

Comparative evaluation of different direct pulp capping agents in carious tooth: An in vivo study.

BACKGROUND: The success of direct pulp capping (DPC) depends on the preoperative assessment of pulpal status, intraoperative judgment after pulp exposure, and the biomaterials used to cap the pulp. AIM: The study aims to compare the clinical and radiographic responses of the pulp-dentin complex after DPC with TheraCal LC, Biodentine, and current gold standard mineral trioxide aggregate (MTA) Plus. MATERIALS AND METHODS: Ninety vital permanent teeth with Class I deep carious lesions were randomly divided into three different groups. After the caries excavation, hemostasis was established using sodium hypochlorite at the site of pulp exposure on which the material was placed. Clinical and radiographic follow-ups were performed at 1-, 3-, and 6-month intervals. RESULTS: Overall success rates of MTA Plus, Biodentine, and TheraCal LC were statistically insignificant. CONCLUSIONS: TheraCal LC and Biodentine showed similar success rates when compared to MTA Plus and can be used as an agent in DPC.

Oxygen inhibition layer: A dilemma to be solved.

OBJECTIVE: This study aimed to evaluate the thickness of oxygen inhibition layer (OIL), produced on various composite materials, and to compare their interlayer shear bond strength (SBS), by treating the OIL with various agents. MATERIALS AND METHODS: The thickness of OIL of three different composite materials (120 specimens divided into three groups) Group 1 - Ivoclar Tetric N-Ceram (nanohybrid composite), Group 2 - Ivoclar Te Econom Plus (microhybrid composite), and Group 3 - GC EverX Posterior (a short glass fiber-reinforced composite) was evaluated. Each group was divided into four subgroups (A, B, C, and D) depending on the surface treatment given - no surface treatment (control group), ethanol, water spray, and grinding with SiC paper. This was followed by interlayer SBS testing. STATISTICAL ANALYSIS: The data were statistically analyzed using ANOVA at a significance level of P < 0.05. Tukey's post hoc analysis was performed following ANOVA to determine differences among the groups. RESULTS: The control group showed higher SBS irrespective of the type of composite material. The group treated with SiC paper resulted in the lowest interlayer SBS among all groups. Glass fiber composite showed higher interlayer SBS compared to both nanohybrid and microhybrid composites, irrespective of the surface treatment given. CONCLUSION: The OIL, which acts as an intermediate layer, is retained on the surface of the composite even after treatment with ethanol and water spray. The presence of an OIL improved the interlayer SBS of two adjacent composite layers and led to more durable adhesion. Rather, the absence of an OIL adversely affected the bond strength and led to adhesive interfacial failures.

Assessment of various genetic components through NCD-I and NCD-III designs of biparental mating in opium poppy.

Creation of genetic variability and development of varieties having higher yield potential depends on information about nature of gene action. The present investigation was undertaken to decipher the nature of gene action and allied genetic parameters involved in the inheritance of yield and yield-related component traits in opium poppy (Papaver somniferum L.). The biparental inbreeding progenies derived from four segregating base populations of crosses NB-1Kr40-3/3×NB-1Kr30+0.2-2/1, NB-5Kr40-7/2×58/1, NB-1Kr30+0.2-2/1×58/1 and NB-Kr40-3/3×NB-5Kr40-7/2 of opium poppy were analysed to study the gene actions involved in the inheritance of yield and component traits. Additive component of variance played a predominant role in North Carolina design (NCD)-I, while both additive and dominance genetic components were found important in NCD-III design. The presence of additive as well as nonadditive components of variance suggested that one or two generations of intermating in further generations followed by selection may lead to development of novel genotypes.

Stereomicroscopic evaluation of defects caused by torsional fatigue in used hand and rotary nickel-titanium instruments.

OBJECTIVE: The aim of this study was to evaluate defects caused by torsional fatigue in used hand and rotary nickel-titanium (Ni-Ti) instruments by stereomicroscopic examination. MATERIALS AND METHODS: One hundred five greater taper Ni-Ti instruments were used including Protaper universal hand (Dentsply Maillefer, Ballaigues, Switzerland), Protaper universal rotary (Dentsply Maillefer, Ballaigues, Switzerland), and Revo-S rotary (MicroMega, Besançon, France) files. Files were used on lower anterior teeth. After every use, the files were observed with both naked eyes and stereomicroscope at 20× magnification (Olympus, Shinjuku, Tokyo, Japan) to evaluate defects caused by torsional fatigue. Scoring was assigned to each file according to the degree of damage. STATISTICS: The results were statistically analyzed using the Mann-Whitney U test and the Kruskal-Wallis test. RESULTS: A greater number of defects were seen under the stereomicroscope than on examining with naked eyes. However, the difference in methods of evaluation was not statistically significant. Revo-S files showed minimum defects, while Protaper universal hand showed maximum defects. The intergroup comparison of defects showed that the bend in Protaper universal hand instruments was statistically significant. CONCLUSION: Visible defects in Ni-Ti files due to torsional fatigue were seen by naked eyes as well as by stereomicroscope. This study emphasizes that all the files should be observed before and after every instrument cycle to minimize the risk of separation.